“44 Ill-treatment or neglect (1) Subsection (2) applies if a person (‘D’ ) - (a) has the care of a person (‘P’) who lacks, or whom D reasonably believes to lack, capacity, (b) is the donee of a lasting power of attorney, or an enduring power of attorney (within the meaning of Schedule 4), created by P, or (c) is a deputy appointed by the court for P. (2) D is guilty of an offence if he ill-treats or wilfully neglects P.”
“2 People who lack capacity (1) For the purposes of this Act, a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. (2) It does not matter whether the impairment or disturbance is permanent or temporary. (3) A lack of capacity cannot be established merely by reference to – (a) a person’s age or appearance, or (b) a condition of his, or an aspect of his behaviour, which might lead others to make unjustified assumptions about his capacity. (4) In proceedings under this Act or any other enactment, any question whether a person lacks capacity within the meaning of this Act must be decided on the balance of probabilities. (5) … (6) ...”
“Parliament has made the position on capacity clear in relation to subsections (1)(a) and (1) (c) and could easily have done so, if that was their intention, in relation to (1)(b). For example, subsection (1) of Section 44 could have been drafted to give effect to the submissions of Miss Wade [counsel for the Appellant] in the following way. Where a person (P) lacks capacity and (a) D knows or reasonably believes P lacks capacity, (b) D is the donee of an LPA or registered EPA created by P or (c) is a deputy appointed by the court for P, then the effect could easily have been achieved. That is not what Parliament has said. There is no need on the face of the legislation for either a lack of capacity to be known or believed by D, nor that there has been a finding elsewhere on the balance of probability that incapacity exists.
“6. In order to reach your verdict you must answer the following questions: (a) Are we sure that CK required medical help (either physical or mental) or care for her personal needs to protect her health ? If yes go to question b); if no then the verdict is not guilty. (b) Are we sure that [the Appellant] appreciated that she needed such help? If yes, go to question d); if no go to question c). (c) Are we sure that [the Appellant] metaphorically ‘closed the door’ on CK such that she did not care (was indifferent/could not face helping her) whether she required medical help/care for her welfare ? If yes, the verdict is guilty and you do not need to consider (d) and e) below; if no then the verdict is not guilty. (d) Are we sure that [the Appellant] failed to seek to obtain the help/care that was required in a) above? If yes, go to question e) if no, then the verdict is not guilty. (e) Are we sure that it was unreasonable for [the Appellant] not to seek to obtain that help/care in the circumstances that were known to her (or that c has applied) ? If yes, the verdict is guilty; if no, the verdict is not guilty. (It is not reasonable if someone is indifferent or does not care whether or not to seek help.)”
“34. The question emerges: in respect of what matter does a person need to lack capacity for the purpose of section44(1)(a) which creates the criminal offence charged in the present case? The appellant sought to argue before the judge that section 44(1)(a) is so vague that no prosecution could succeed. As we have seen, “capacity”, as treated by the 2005 Act [in s 2(1)] , is not an absolute condition. Whether a person has capacity must be ascertained in the context of the matter under consideration in respect of which a decision must be made. A person may have capacity to decide what to eat but no capacity to decide whether to accept medication or to employ a particular carer or to sell a car or a house. Section 44 does not specify in respect of what matter the incapacity of the person must be proved. Section 44 requires proof either that the person lacks capacity in respect of a matter which is unidentified or that the defendant reasonably believed that the person lacked capacity in respect of a matter which is unidentified. On first reading, therefore, an offence charged under section 44(1)(a) is incapable of proof.”
“40. Unconstrained by authority, this court would be minded to accept the submission made on behalf of the appellants that section 44(1)(a), read together withsection2(1) of the Mental Capacity Act 2005 , is so vague that it fails the test of sufficient certainty at common law and under Article 7.1, ECHR. However this court has made a decision uponsection 44of the Act which binds this court. 41. In R v Clare Dunn[2010] EWCA Crim 2395 , this court (Lord Judge CJ, Mr Justice Calvert-Smith and Mr Justice Griffith Williams) considered a submission made on behalf of the appellant that directions given to the jury by the Recorder were insufficiently explicit in their assistance to the jury upon the meaning of ‘a person without capacity’. The appellant had been convicted upon four counts alleging ill treatment, contrary to section 44 (1) (a) and (2)of the Act.”
“45. Further submissions were made on behalf of the appellants as to the interaction between section 44 and section 2(4) of the Act. It was argued that section 2(4) should be construed as inapplicable to proof of the criminal offence. Unless expressly stated to the contrary, it is a principle of criminal law in England and Wales that a burden of proof placed on the prosecution must be established to the criminal standard, namely so that the jury is sure of guilt. Section 2(4) provides that in ‘proceedings’ under the Act or any other enactment, any question whether the person lacks capacity within the meaning of the Act must be decided on the balance of probability. 46. There are, it is observed, many and various ‘proceedings’ in which the existence of capacity will require precision, not least in proceedings in the Court of Protection. The word ‘proceedings’ is however apt to describe both civil and criminal proceedings. We cannot assume that Parliament intended section 2(4) to apply to all proceedings except those contemplated by section 44. Had the intention been to exclude section 44 from the operation of section 2 (4), then we can see no reason why that could not have been achieved explicitly.”
“2(1) Subject to sub-paragraphs (5) and (6) and paragraph 20, a power of attorney is an enduring power within the meaning of this Schedule if the instrument which creates the power— (a) is in the prescribed form, (b) was executed in the prescribed manner by the donor and the attorney, and (c) incorporated at the time of execution by the donor the prescribed explanatory information.”
"In Consultation Paper No 128 we provisionally proposed that the existing offence of ill-treating a "mentally disordered patient" should be extended to protect anyone without capacity. Many respondents supported the creation of a new offence, and also expressed concern about the efficacy of the criminal justice system in protecting people with mental disabilities. The points they raised about the attitude of the police and prosecuting authorities, and about the inflexibility of procedural rules which mean that witnesses with disabilities do not get the help they deserve, are outside the scope of this project. We do, however, see a need for a specific offence of ill-treatment, independent of the existing offence in the Mental Health Act. The new offence should address the fact that the draft Bill creates a number of ways in which a person can acquire powers over another person who lacks some decision-making capacity. It is right that a person with such powers should be subject to criminal sanction for illtreating or wilfully neglecting the other person concerned."
“A New Offence to III Treat or Wilfully Neglect a Person Without Capacity 1.36. The Law Commission recommended that it should be an offence for a person to ill-treat or wilfully neglect a person in relation to whom he or she has responsibility under the new legislation. This would relate to people appointed as managers by the court; donees of CPAs; and those having care of, or in lawful control of, the property of the person without capacity. 1.37. Many respondents were keen to support sanctions for ill treatment and supported the idea of a new offence. The Government recognises that ill treatment of a person without capacity is a very serious matter. However, while the Government has not ruled out the need for such legislation, it is not persuaded that the creation of a new offence would be the best way of tackling abuse.”
“1. The Draft Mental Incapacity Bill and accompanying Commentary and Explanatory Notes were presented to Parliament on27 June 2003 by Lord Filkin, the Parliamentary UnderSecretary of State for the newly-created Department for Constitutional Affairs. Consultation 2. The draft Bill is the result of a very lengthy and detailed process of consultation. As long ago as 1989, the then Lord Chancellor, Lord MacKay of Clashfern, invited the Law Commission of England and Wales to carry out a comprehensive investigation of all areas of the law affecting decisions on the personal, financial and medical affairs of those who lack capacity. This was in response to concerns raised by professional bodies and voluntary organisations dealing with mental disability 3. Following five years of consultation and deliberation, the Law Commission produced its final report and recommendations for Law Reform in March 1995. The Commission recommended that "there should be a single comprehensive piece of legislation to make new provision for people who lack mental capacity". … 7. In response to the Law Commission Report, the (then) Lord Chancellor's Department published a Green Paper ‘Who Decides’ in December 1997 and, after a further consultation, a policy statement entitled 'Making Decisions' in October 1999. This set out the Government's commitment to bring forward new legislation ‘when Parliamentary time allows’ … 8. Following the publication of the Green Paper, the (then) Lord Chancellor's Department established the Mental Incapacity Consultative Forum. This was designed to work with stakeholder organisations, to develop solutions to problems which exist under the current law and to explore proposals for new legislation. The Department also produced a series of six booklets giving guidance on the existing law respectively for legal practitioners, social care professionals, health care professionals, family and friends, people wishing to prepare for possible future incapacity and those with learning difficulties. Meetings and consultation seminars with those representative groups, organised by the Department, to discuss the scope for law reform eventually led to publication of the draft Bill.”
“42 Ill-treatment or neglect (1) A person is guilty of an offence if he— (a) has the care of a person who lacks or whom he reasonably believes to lack capacity, or is the donee of a lasting power of attorney or a deputy appointed for a person by the court, and (b) ill-treats or wilfully neglects the person concerned. (2) A person guilty of an offence under this section is liable – (a) on summary conviction, to imprisonment for a term not exceeding 12 months or a fine not exceeding the statutory maximum or both; (b) on conviction on indictment, to imprisonment for a term not exceeding 5 years or a fine or both.”
“271. Clause 31 of the draft Bill proposes the creation of a new criminal offence where an attorney or deputy or someone who has care of an incapacitated person ill-treats or wilfully neglects that person. While this additional protection is to be welcomed, the Master of the Court of Protection has pointed out that it appears to relate solely to physical ill-treatment and does not cover financial abuse.”
“On the face of it that is clear and simple language. Its purpose is to provide for the protection of those who are mentally disadvantaged from any form of ill-treatment.”
“But we pause to remember the purpose of section 44 and the creation of the offence; and bear in mind that everyone, who for whatever reason but in particular the natural consequences of age, has ceased to be able to live an independent life and is a vulnerable individual living in a residential home, is entitled to be protected from ill-treatment if he or she lacks ‘capacity’ as defined in the Act.”
“The Act introduces two new criminal offences: ill treatment and wilful neglect of a person who lacks capacity to make relevant decisions (section 44). The offences may apply to: • anyone caring for a person who lacks capacity – this includes family carers, healthcare and social care staff in hospital or care homes and those providing care in a person’s home • an attorney appointed under an LPA or an EPA, or • a deputy appointed for the person by the court.”
“Section 44 of the Act introduces a new offence of ill treatment of a person who lacks capacity by someone who is caring for them, or acting as a deputy or attorney for them. That person can be guilty of ill treatment if they have deliberately ill-treated a person who lacks capacity, or been reckless as to whether they were ill-treating the person or not. It does not matter whether the behaviour was likely to cause, or actually caused, harm or damage to the victim’s health.”